Work-related Neck Disability

24 May 2022


Heightened Pain Facilitation, Low Vigorous Physical Activity, and Psychosocial Distress Predict Unfavourable Outcomes of Work-related Neck Disability

What is the research about?

Neck pain is common among workers in high-risk occupation groups such as sonographers, whose work involves ultrasound scanning with sustained static postures and forces and intensive computer-based tasks. To direct better management strategies, our study identified and described sonographers with different pathways of neck disability over 12 months and investigated which baseline biological, psychological, work-related physical and social factors contributed to the identified pathways.

What did the researchers do?

We recruited 92 sonographers with and without neck pain and disability. At baseline, we used standardised questionnaires to measure sonographers’

  • demographics, neck disability level, physical activity levels;
  • work-related physical and social  factors: e.g., ergonomic risk, workplace social support, job satisfaction);
  • general psychological features, e.g., depression, anxiety, negative emotional response to pain, and avoidant behaviour towards work activities because of fear of pain;

At baseline, we also conducted specialised testing called quantitative sensory testing to assess sonographers’ pain responses to different stimuli (e.g., heat, cold and pinprick), which helped us to understand whether the pain message is amplified by the brain. After sonographers completed their baseline assessment, we followed them up at 6 and 12 months to assess their neck disability level.

What did the researchers find?

Thirty five percent (35.2%) of sonographers developed persistent moderate neck disability, while 64.8% showed slow improvement from mild to no disability over 12 months.

Sonographers were more likely to have persistent neck disability if they had more severe symptoms, lower vigorous physical activity, higher ergonomic risk, lower job satisfaction, lower workplace social support, anxiety, depression, and pain amplification features at baseline.

What you need to know:

Many sonographers experience work-related pain during their career. Our study shows one in three sonographers is at risk of developing persistent neck pain and disability. Clinicians such as physiotherapists may identify groups of workers such as sonographers at risk of developing unfavourable outcomes through screening of risk factors and tailoring treatment or management strategies for individual workers. This research suggests a multifaceted approach is needed to reduce risk, including ergonomic and workplace support strategies and a focus on individual workers to improve vigorous physical activity levels and mental health.  

How can you use this research?

Although the population of interest for this study is sonographers, our findings are generalisable to other occupations with similar physical and psychosocial work demands, such as dentists and laboratory technicians. Our team is working on solutions with sonographer organisations and sonographers to reduce neck and other musculoskeletal pain and disability. If you would like to partner with us or contribute to our research, contact us at or

About the researchers

Dr Yanfei Xie

Dr Yanfei Xie is a postdoctoral research fellow at RECOVER Injury Research Centre.

Dr Brooke K Coombes is a lecturer in physiotherapy at the School of Health Science and Social Work, Griffith University.

Dr Lucy Thomas is a senior lecturer in physiotherapy at the School of Health and Rehabilitation Sciences, The University of Queensland.

Dr Venerina Jonhston is an Honorary Associate Professor at The University of Queensland and has qualifications in physiotherapy, occupational health and safety and work disability prevention.


Xie Y, Coombes BK, Thomas L & Johnston V (2022). Time Course and Risk Profile of Work-Related Neck Disability: A Longitudinal Latent Class Growth Analysis. Phys Ther.


Biopsychosocial Risk, Central Sensitization, Disability Trajectory, Neck Pain, Prospective Study, Quantitative Sensory Testing

Contact information, acknowledgements

Dr Yanfei Xie


RECOVER Injury Research Centre, The University of Queensland